Bell's palsy eyelid recovery (and surgical options)?

[MemK]

I was diagnosed with Bell's palsy about three months ago. I've recovered some movement (a partial smile, ability to partially raise my affected eyebrow). However, my lower eyelid began to droop a few weeks ago. I use drops and gel to keep my eye lubricated, and I tape it closed at night. I still cannot fully close my eyes on my own. Today, my ophthalmologist referred me to an ocular plastic surgeon to explore temporary and permanent options to improve the function of my lower eyelid. Not sounding all that hopeful, she said not to lose hope that my lower eyelid might still recover. Has anyone recovered use of their lower eyelid months into their diagnosis (I'm still hoping for spontaneous improvement before my mid-December appointment with the plastic surgeon)? Has anyone explored or undergone surgery for eye issues after their Bell's palsy diagnosis? I'd appreciate learning more about your experience.

[Vane91]

Don’t loose hope!!! I was exactly where you were at 3 months it will slowly recover. I got BP at in 2018 at 27.

Advice!!!! Please, please do not force your eye shut!!! let it run its course doing minimal face stretches. I would force my eye to shut and I now have synkinesis which is abnormal involuntary facial movement. Try not to stress (easier said than done)

Drops suck use lubricant eye gel and continue to tape your eye shut.

[RaisyDaisy]

Yes, lots of improvement to come after 3 months! Unfortunately this journey requires so much patience. It’s very hard and my heart goes out to you. It sucks that we have to deal with this.

I can’t speak directly to the lower eyelid issue, but the timing of it reminds me of an issue I had. My eye closure had gotten pretty good in that timeframe, only a sliver left open. Then suddenly I regressed considerably with it, and also showed synkinesis where the corner of my mouth rose when I tried raising my eyebrows.

I started seeing a specialist physical therapist, who has been a tremendous help. Her perspective is that incomplete eye closure can be implicated in developing synkinesis. Because closing your eye is so important, your brain is shouting at all your muscles to help. In my case, spasms and tightness in my forehead muscles kept the inner corner of my upper lid from going down.

This is all so complicated. I’m not an expert and I don’t mean to make you nervous, but I think consulting an expert physical therapist (in addition to the ocular plastic surgeon) could empower you. I wonder if there could be some activation in your cheek muscles pulling it down. Anyway, take that with a grain of salt. It’s hard to find people truly knowledgeable about the condition, but I found it such a relief to put myself in someone’s hands who’s seen it all before.

I wasn’t recommended for surgery, but I do wear a stick-on eyelid weight. I can close my eye without it, but the corner of my mouth does want to tick up. The little bit of help from the weight keeps the rest of my face from getting involved as much. And the neuromuscular retraining exercises, massage and stretching I do are helping. (These are customized to me by the therapist.) One year out and my blink keeps getting better. The synkinesis is the most annoying part.

The lower eyelid surgery I was told about is tacking it up with a few stitches. I think it’s not too invasive or scary. My perspective is the earlier you intervene, the better you can minimize unwanted complications. I know it’s hard to wrap your head around being one of the people who doesn’t just get better on their own. Things will not always be as bad as they are today. Keep us posted on how things go!

[MemK]

Thank you, Vane91 and RaisyDaisy! It's reassuring to know that improvement is possible beyond three months. I appreciate the eye care tips. This part of my recovery has been an unexpected challenge. I agree that it's difficult to find people truly knowledgable about this condition. RaisyDaisy, I've scheduled an evaluation for neuromuscular retraining with an experienced clinician. Thank you for sharing your own therapy experience. I feel more hopeful than before. Wish you both well!

[Mrs_Ballroom]

All I know from my experience & the facial palsy specialists I work with is that if your eye doesn’t close in 6 mo and if your face doesn’t almost fully recover in that time frame it’s more than likely not BP. I had 5 docs in my area misdiagnose me. I had the Shingles virus w/o a rash called Zoster Sine Herpete. Did you have intense ear pain around your onset? 9 mo in I found people who are palsy specialists. I was put on antivirals for a year (b/c this virus can come back easily) and have started PT with some painful needling out of the fibrosis. I look normal at rest now & my smile is just starting to turn up. Praise God! I’m not interested in surgery. Maybe you can look into these possibilities first. Best of luck!

My doctor: Michael Reilly at MedStar health

My PT: Jodi Barth at The Center For Facial Recovery

[Mrs_Ballroom]

…I’m 1yr 7mo in. I started with specialists only 11 mo ago with fantastic results.